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AMA: Physicians Outraged At Steep Medicare Cut (UPDATE)

piggy bankFrom the AMA:

UPDATE:  Last night, the U.S. Senate voted yet again to delay the 21 percent Medicare physician payment cut for one month, postponing it until April 1. The Senate should use this time to permanently repeal the flawed Medicare physician payment formula that puts access to care for seniors and military families at risk.

WASHINGTONThe U.S. Senate’s failure to act before today’s 21 percent Medicare physician payment cut has put seniors at grave risk of reduced access to health care and choice of physician.

“The Senate had over a year to repeal the flawed formula that causes the annual payment cut and instead they abandoned America’s seniors, making them collateral damage to their procedural games,” said AMA President J. James Rohack, M.D. “Physicians are outraged because the cut, combined with the continued instability in the system, will force them to make difficult practice changes including limiting the number of Medicare patients they can treat.”

Physicians from across the nation are in Washington, D.C. this week for the AMA’s National Advocacy Conference and will meet directly with their senators to tell them it is urgent that they permanently repeal the flawed Medicare physician payment formula and replace it with one that reflects the increased cost of caring for patients.

“The AMA is hearing directly from physicians, and seniors should be very concerned about how the Senate’s inaction will impact their ability to see a doctor,” said Dr. Rohack. “Military families are also hurt as TRICARE ties its payment rates to Medicare.”

Messages to AMA from practicing physicians about today’s 21 percent cut include the following letters in their own words.

Psychiatrist, Washington, D.C.

“As a practicing psychiatrist in D.C. for over 35 years I have always treated Medicare patients for the Medicare fee, which is already way below the standard fee for my services. I felt this was an obligation to take care of senior citizens. At this point unless this 21 percent reduction in fee is repealed I will have to abandon seeing Medicare patients. I will have to do this with a heavy heart as I will not be able to maintain my practice at these rates. Given the expenses of maintaining a practice where all costs escalate every year — malpractice, licensure, CME credits, rents, administrative fees, etc — it no longer becomes feasible to sustain the practice.”

Primary Care, Duluth, MN

“The sad truth is that we will no longer be able to see Medicare patients who come to establish care with our group. We won’t fire our existing patients I hope. The alternative is to close the doors. To say that this is discouraging is an understatement. I went into medicine with the ideals of serving my patients with a covenant to provide the highest quality care. I can’t do this with the cruel cynical actions of our Congress. I am ashamed of our system. I most likely will quit the practice of medicine.”

Urologist, Chatanooga, TN

“We are now forced to cease seeing new Medicare patients and may have to opt out altogether. This will be a devastating turn of events for us and our community.”

Psychiatrist, New York and Pennsylvania

“I plan to retire as soon as possible if the Medicare cuts go through. Most of my patients will be unable to find another competent psychiatrist who takes Medicare. I am the only one of my colleagues who takes Medicare now.”

Ob-Gyn, Baton Rouge, LA

“These cuts are forcing me to limit the number of Medicare patients I will see. As a private practitioner, all of my expenses are going up including the rent, utilities, malpractice, employee salaries, etc. I want to continue to provide good care to my patients, but if I have to increase the number of patients I see, work longer hours, get less sleep, reduce time with my family, reduce my required medical supplies, etc., continuing to take Medicare will only make it impossible for me to do so in these tough economic times. I will not be the only physician making this tough decision. In reality these cuts will reduce the quality of care to the elderly and increase healthcare costs as the access to preventive care decreases, thus increasing the emergency room visits, intensive care visits, emergency surgical operations and poor medical outcomes. These cuts are a slap in the face to the elderly whom have worked hard and paid into the system that is now turning its back on them when they need it most.

Urology, Cadillac, MI

“I am not sure which is more disruptive; the constant uncertainty each year regarding the SGR, the actual 21 percent cut, or the payment freezes that are now seemingly routine. One thing is for sure. My office will attempt to minimize our exposure to the now-politicized Medicare program. Starting now, we will limit the number of new Medicare patients to 3 per week per provider (down from about 7), and limit surgeries to emergent cases on our existing Medicare patients.”

Family Physician, Muncie, Indiana

“The government continues to encourage the use of EMR’s. However, these systems are extremely costly to maintain. These cuts are making it impossible to pay for expensive EMR systems, and we are considering going back to paper charts.”

2 comments

  1. Dr. S (Family Medicine / Plano TX)

    Dr. Ziev is wrong.
    Our three doctor Family Medicine practice has opted-out of Medicare.

    Many doctors in our I.P.A. are doing the same (and others did it long ago).

    Quite frankly, you’d have to be one f***ing crazy doctor to continue participating at this point.

    Our Medicare patients continue to see us on a cash-basis. They appreciate the generous time and attention that we give them, and are charged very fair rates.

    I didn’t become a Family Doctor to get rich, but I certainly didn’t become one to get poor. 21% my ass…

  2. From Dr. Ziev:

    I have been following this story. The AMA and AOA have sent notices to physicians
    telling them how to withdraw from participation in Medicare. It will be interesting
    to see how the doctors respond to the 21% cut. My personal belief is that they will
    do nothing but complain. They will probably continue to participate. They never
    learn.

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